Infectious Disease (ID) remained a common cause of hospitalization and ambulatory visits in the United States [1] [2] . There has been an increasing trend of hospitalization due to ID, especially among older adults [3] - [5] ). A study published in 2009 [3] showed approximately 4.5 million hospital days and $865 billion in hospital charges associated with primary infectious disease management.

Our study is a data base of inpatient and outpatient ID consultations of one infectious disease specialist’s (Eyassu Habte-Gabr) experience in a major community teaching hospital. Briefly, it is a descriptive study of the overall ID burden and patterns of infection by age, gender, race and season.

All consultations were performed at patients’ bedside in the hospital and in examination rooms in the ID clinic. The purpose of the consultations had been for complete management of ID of patient.

The objectives of the study a) to acquire information on spectrum of ID admissions to hospital and ambulatory visits from one ID specialist’s experience; and b) analyze by age, gender and race and determine of any trends over a ten-year period.

This data base for years 2001-2010 included 5605 ID encounters. The majority were inpatient (81%), with almost an equal distribution by gender (M/F = 51%/49%) and race (52% African American and 48% Caucasian). There is a fairly good age group distribution but higher in 60 years and older (33%), followed by 32% in ages 45 - 59, 23.5% in 30 - 44 and 10.1% in 18 - 29 years. A small number (76 or 1.4%) younger than 18 were also seen.

Skin and soft tissue infections were the most common cases in inpatients (27.9%) and the second most common cases in an outpatient setting (23.3%). A quarter of inpatients had septicemia. By far, the most common cases seen in an outpatient setting were HIV/AIDS.

Skin and soft tissue infections (27.1%), septicemia (19.45%), and osteomyelitis (11.98%). Other diseases were HIV/ AIDS (9.46%), urinary tract infection (7.63%), respiratory tract infection (6.39%), and febrile illness (5.48%).

SSTIs equally affected all ages; osteomyelitis and septicemia diagnosis increased with age (Figure 3); UTI were in extreme ages (below 29 and above 60). Most HIV/AIDS patients were below 44. The major racial differences (Figure 5) are 1) SSTI higher in Caucasian (31% vs 23%), and 2) septicemia among African/American (23% vs 16%). The main higher gender difference in ID occurrence are in 1) osteomyelitis in males (61% vs 35%); 2) UTI in females (65% vs 35%) and 3) HIV/AIDS in males (72% vs 27%).

Knowledge about varieties and frequencies of ID diagnosis as seen by a specialist has significance for develop-

ment of teaching programs, rendering quality services, and planning for research priorities. This research on cases seen on ID consultation in a large teaching hospital, over an extended period of time, shows the reality of ID specialist daily activities in patient management and teaching of house staff and medical student in both inpatient and outpatient settings. This study is different from a study that looked at ID admissions from national data base [3] , which did not specifically look at only ID consultations. For instance, respiratory tract infection ranked first but fifth in our case reviews where most patients are likely to be managed by primary care physicians and/or pulmonary specialist. Besides 20% of cases are ID consults and follow-ups at the hospital based ID clinic.

A recently published but a prospective study that we can compare our ID consultation experience was done in 53 hospitals in the Far East (Australia, New Zealand and Singapore) [6] . This was a two-week survey on ID specialists’ activities. Similar to our study, skin and soft tissue infection (SSTI) was the most infection. Other common infections were respiratory tract and bone and joint infections. The shift to SSTI from respiratory tract infection has been attributed to increase prevalence of methicillin resistant Staphylococcus aureus (MRSA). There has been increasing trend in SSTI emergency department visits and admissions [7] [8] .

Age and sex distribution of ID cases is as expected; women in extreme ages were more likely to have UTI and HIV/AIDS was higher in the below 44 and males. Older age population are more susceptible to infections due to decrease of T-cell function and comorbidities as seen in our hospital. There is increasing trend in the burden of ID hospitalization towards elderly in last decade [1] . This trend is clearly observed in our series more in septicemia and osteomyelitis. The increasing incidence of infections in the older age group will have a significant impact on the US health system which is expected to double by 2030.

Our study being a retrospective one has some limitations. These are unavailable/incomplete information of microbiologic data, outcome, site of acquisition of infection, details of some predisposing factors, and antibiotic use.

Our study reflects an experience of inpatient and outpatient consultation in a large teaching hospital during a regular routine year round functioning period unaffected by epidemic, population changes (example influx of returnees from abroad and unusual climatic variations. Consultations included on fairly well distributions of adult ages, race and gender. This study shows a wide spectrum of ID involving all systems.

This data collection and analysis can lead to prospective study using data base information for transfer to electronic recording of patient information, labs, imaging studies and follow-up, impact on some aspects of patient management (length of stay), cost and evaluation of antibiotic use in the hospital.

The author would like to acknowledge Jinu Puthenparampil MD for his assistance with data collection and Nicolas Lecea BS for his assistance with data analysis.

Eyassu Habte-Gabr, (2015) Adult Infectious Disease Consultation over a 10-Year Period in a Community-Base Teaching Hospital. Open Access Library Journal,02,1-6. doi: 10.4236/oalib.1102128